HomeMy WebLinkAbout1999-011170 - plumbing► f . } PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - ..�_�-;;;��i.;
Crystal Bay, Minnesota 55323 Permit Number. ;Y;`�'����,=_�
(612}473-7357 Date Issued: �_�� .;;�:;,_::�
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
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� CITY OF URONO APPLICATION FOR PLUMBING PERMIT
}Sox bb (2750 Kelley Parkway)
Crystal Ba,v, NIN 55323
GENERAL 1NFORMATION .
1. You may apply for plumbing permits by mail or in person at ttie Ciry offices. � .
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners residing
in the dwelling.
4, When any new construction or rcmodeling is involved, a sepazate building permit must be obtained.
5. � All work must be done in accordance with the State Code requirements.
6. All work must be inspected and air tested before it is covered. Ca11473-7357, 24-hour notice reequired.
Instruction� Co�nplete all items on this application. Compute the permit fee. Sign and date
the certificatioii. INCOMPLET� APPLICATIONS WILL NOT BE PROCFSSED. If you have
questions, cal! 473-7357.
Please check one: New Addition �_ Repair .�1._ Replace
�— Residential Commercial
JOB SI1'E: .3� 9� �YRr c. A�/ � G n.o a o Zip: .��' 3�3
Owner's Name: 7"e�i Ij uR ,Y Evi k Telephone Number: y�3 - Sf 8'4
MailingAddress: a 2. ys F r{��,c�, c.gx+ J���o Citys �vAy.�dt� Zip: sr39i
� Contractar'sName: To�i /���rL N�v,k TelephoneNumber: ��� -ss&�a
MailingA.ddress: ,�� �s r2��►c,� �_.d.k�- ��vr�, City: w.9-y��-t� Zip:, �5'�3� 3
f�`J�'/L:S f�LviyG'/N6 1316 �c� ��'S7` Sr ,BvFFisLo .F,w. 5s3/3-4d>�_ 6/�--6 f.� -5�1//
; �V�,L L g�`�.v�- o�,�:,� PLUMBING F�TURE SCHEDULE
FIXTUR.E BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND - OTHER
TYPE FL 'FL TYPE FL FL ,
Water Closet Floor Drains -x
Lavatory ?( ' Sewer Ejector
Bathtub X Laundry Tray 'X
Shower Washer
Kitchen`8ink x Water Heater �(
Disposal Water Softener
Dishw��sher X Wet Baz
Sillcocks x-a.. Misc (list)
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
fi G.OvC� x .0125 $
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcfiarge to each permit. x .0005 $
. (contract price)
or $.50, whichever is greater
3. Posta�e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the permitted
work including materials, labor, profit, and other fued costs. It is the amount to be charged to the
customer for the work done. If any material, equipment, labor,or installation aze furnished by the owner,
tenant or any other party the reasonable market value of such items must be added to the estimated cost
or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ciry may request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over$1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certi�es that all statements made on this application are complete, true and
correct.
Applicant's Signature: � Date: /—/y"l�